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13 Things to Know If You Have a Lung Nodule

Lung nodules can show up on an x-ray as a spot on the lung—and they can be cancer, though not always. Here's why they may not be as scary as they sound.

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Lung nodules in the news

In December 2018, CNN reported that Supreme Court Justice Ruth Bader Ginsberg had two cancerous nodules removed from her left lung. That sounds incredibly frightening—especially because she is 85 years old and suffered a fall in November. So, what do you need to know about lung nodules? Is a spot on the lung always cancer?

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What is a lung nodule?

Think of your lungs like a sponge, says the Brigham and Women’s Hospital. They’re made up of small air sacs and blood vessels. A lung nodule is a small solid clump of tissue in the lung, and on a chest x-ray they can show up as a spot on the lung.

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Why do I have a nodule?

A lung nodule can be caused by several things, according to the experts Brigham and Women’s Hospital: Enlarged lymph nodes, infections (such as pneumonia), fungal lung infection (aspergillosis), phlegm, scars, cysts, and lung cancer.

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Won’t I know if I have one?

You probably won’t. While you might expect that a lung nodule would cause breathing problems or even chest pain, it’s unlikely you’d “feel” it at all. And they’re incredibly common. In as many as half of adults getting an imaging scan of their chest, doctors find a spot on the lung that indicates a nodule, according to the American Thoracic Society (ATS). Make sure you know these 14 health myths even doctors believe.

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Okay, then how is a lung nodule detected?

Although it’s unlikely you’ll feel symptoms of a lung nodule, if you’re dealing with a respiratory illness or another breathing issue your doctor may order a chest x-ray or CT scan to help determine what may be going on. It’s via one of these imaging tests that doctors often first see a spot on the lung that could indicate a lung nodule, says the Cleveland Clinic. The nodule can appear as a round or oval spot.

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Is it cancer?

Here’s the good news: It’s probably not cancer. More than half of all lung nodules discovered are benign, according to the US National Library of Medicine. The risk that they’re cancerous is largely based on their size. Those that are less than 6 mm in diameter are unlikely to be cancer; unfortunately, those over 10 mm are 80 percent likely to be cancerous.

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Has it changed?

And then there are the lung nodules that fall in between 6 mm and 10 mm. Doctors will watch those and other smaller nodules; if they don’t grow or change in follow-up imaging scans, the lung nodules are probably benign, says the Mayo Clinic. If the spot on the lung is changing, you may need a biopsy, another CT scan, or a PET scan.

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So it is cancer?

Hearing that your nodule is cancerous can be a shock, especially when you weren’t experiencing symptoms. But according to the ATS: “Even if a nodule turns out to be lung cancer, it is likely to be an early-stage lung cancer. People with early-stage lung cancer are less likely to die of lung cancer than people who are diagnosed at a later stage, when cancer has started to cause symptoms.” FYI: These Canadian provinces have the highest rate of cancer.

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What if it grows?

According to the ATS, if you’re on a wait-and-watch schedule, you can rest easy that any changes between scans will be minor and leave plenty of time for you and your doctor to come up with a treatment plan. A spot on the lung that does turn out to be cancer tends to be slow-growing; surgery or radiation are effective treatments, they note. Learn 12 diseases your doctor can actually detect through smell.

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A blood test may help

A recent study published in the journal Chest revealed that a new blood test can spot specific proteins in blood and, in combination with a doctor evaluation, can accurately spot benign or cancerous nodules 98 percent of the time.

“Our goals for this biomarker are to help calculate the risk of cancer, present the patient with options and recommendations, and avoid subjecting patients with a benign disease to expensive, unnecessary and intrusive procedures,” said study author Gerard A. Silvestri, MD, MS, in a press release.

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Treating a lung nodule

If the nodule is benign, your doctor will leave it alone because it probably won’t get any bigger. They will treat any underlying condition, such as an infection, that may have lead to the development of the nodule in the first place though. If the nodule is cancerous, your doctor may advise removing it with surgery, such as a thoracotomy, a technique that removes the affected part of the lung, says the Cleveland Clinic. Here’s 10 things doctors secretly wish they could tell you.

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How can you prevent one?

Don’t smoke. If you do smoke, quit. Of course, those who smoke know that’s not as simple as it sounds. And because it can be a difficult process full of ups and downs and multiple attempts, learn about how quitting smoking can actually improve your complexion.

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Don’t be afraid to ask questions

Because radiologists often detect lung nodules from an x-ray accidentally, patients can feel scared and confused about the news. One problem is that even though doctors know that most nodules are benign, they don’t often tell patients that it’s probably not cancer, and it’s the lack of communication that can cause a lot of anxiety, finds a 2018 study in Chest. So ask questions, say the study authors, who tried various strategies to decrease stress. “Patients across the board asked for more information about nodules, and those who received it more often found this information reassuring instead of upsetting, according to the review,” Christopher Slatore, MD, of the VA Portland Health Care System said in a press release. When it comes to a lung nodule, more information is better. Next, find out 29 things that don’t actually cause cancer.

Originally Published on Reader's Digest